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Reproductive Sciences (Thousand Oaks,... Jul 2015This study was undertaken to test the hypotheses that, due to gradual accumulation of dead erythrocytes and their ingested products resulting from repeated hemorrhage,...
This study was undertaken to test the hypotheses that, due to gradual accumulation of dead erythrocytes and their ingested products resulting from repeated hemorrhage, older endometriomas (whitish in color) contain chocolate fluid with higher iron content than younger (brownish/blackish in color) ones with concomitant higher collagen content and more adhesions. We recruited 30 premenopausal women with histologically confirmed ovarian endometriomas and collected samples of their endometriotic lesions and chocolate fluid and measured the viscosity, density, and the concentration of total bilirubin, ferritin, and free iron of the chocolate fluid. We also evaluated the lesion color and adhesion scores. In addition, we performed Masson trichrome and Picro-Sirius red staining on all endometriotic cysts and evaluated the extent of fibrosis in the lesions. We found that fluids taken from white-colored endometriomas had significantly higher concentration of total bilirubin, ferritin, and free iron, respectively, than black/brown-colored ones. In addition, older cysts had fluids that had significantly higher density and viscosity. Fluid density correlated positively with the concentrations of total bilirubin, ferritin, and free iron. Older lesions had significantly more collagen content and higher adhesion scores. Taken together, these data supports the notion that older cysts, having experienced more bleeding episodes, contain chocolate fluid that is higher in viscosity, density, and iron content and higher fibrotic content than younger ones. This provides another piece of evidence that endometriotic lesions are wounds that undergo repeated injury and repair, resulting ultimately fibrotic lesions that are resistant to hormonal treatment.
Topics: Adult; Cyst Fluid; Endometriosis; Female; Humans; Ovarian Cysts
PubMed: 25676579
DOI: 10.1177/1933719115570907 -
Acta Medica Iranica 2014Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to...
Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7 rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts (17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts) underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger teratomas and more parenchyma inadvertently removed during their excision (1.64, 0.255) reduced AFC was seen and in simple serous cysts with more removed parenchyma amount (1.5) reduced AFC occurred. In our study simple cysts excision led to a loss in AFC that was not associated with any other cyst parameters. Mucinous cysts resection led to no specific ovarian reserve damage. Laparoscopic cystectomy for non-endometriosis leads to reduced ovarian reserve.
Topics: Adolescent; Adult; Child; Child, Preschool; Endometriosis; Female; Follow-Up Studies; Humans; Iran; Laparoscopy; Ovarian Cysts; Ovariectomy; Ovary; Prospective Studies; Ultrasonography; Young Adult
PubMed: 24902013
DOI: No ID Found -
Cancer Cytopathology Feb 2018Although ovarian fine-needle aspiration (FNA) cytology is not commonly used as a primary modality of diagnosis for patients with ovarian lesions, many ovarian cysts are...
BACKGROUND
Although ovarian fine-needle aspiration (FNA) cytology is not commonly used as a primary modality of diagnosis for patients with ovarian lesions, many ovarian cysts are aspirated intraoperatively and occasionally for diagnostic purposes. Therefore, the ability to interpret these specimens remains critical. Previous studies have suggested a high specificity but low sensitivity as a limitation. The objective of the current study was to further explore the use and performance of ovarian cyst FNA for diagnosing malignancy at the study institution.
METHODS
The electronic database was searched from 1998 through 2016 for ovarian cyst fluid cytology specimens; any concurrent or follow-up surgical pathology; and clinical information including patient age, radiology findings, and procedure type. Test performance was calculated using the surgical pathology diagnosis as the gold standard.
RESULTS
A total of 459 ovarian cyst FNA specimens had the following diagnoses: 416 (90.6%) were diagnosed as benign, 32 (7.0%) as atypical, 4 (0.9%) as suspicious, and 7 (1.5%) as malignant. Overall, 300 specimens (65.4%) had a corresponding surgical pathology specimen. On follow-up, the rate of malignancy (including borderline neoplasms) for benign FNA was 10 of 264 specimens (3.8%), that for atypical FNA was 0 of 24 specimens (0%), that for suspicious FNA was 5 of 5 specimens (100%), and that for malignant FNA was 7 of 7 specimens (100%). Test sensitivity was 54.0% and test specificity was 100%. The positive predictive value was 1.00 and the negative predictive value was 0.97, with a disease (malignancy) prevalence of 7.33%.
CONCLUSIONS
Ovarian cyst fluid cytology is highly specific and moderately sensitive for the detection of ovarian malignancies. A negative FNA is reassuring for patients with a low pretest probability of malignancy. Cancer Cytopathol 2018;126:112-21. © 2017 American Cancer Society.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Child; Child, Preschool; Cyst Fluid; Databases, Factual; Female; Follow-Up Studies; Humans; Infant; Middle Aged; Ovarian Cysts; Ovarian Neoplasms; Precancerous Conditions; Predictive Value of Tests; Prevalence; Retrospective Studies; Sensitivity and Specificity; United States; Young Adult
PubMed: 28834408
DOI: 10.1002/cncy.21911 -
Frontiers in Endocrinology 2022To investigate the incidence of functional ovarian cysts, its influence on clinical rates, and proper management after depot gonadotropin-releasing hormone (GnRH)...
OBJECTIVES
To investigate the incidence of functional ovarian cysts, its influence on clinical rates, and proper management after depot gonadotropin-releasing hormone (GnRH) agonist pretreatment in artificial frozen-thawed embryo transfer cycles (AC-FET).
METHODS
This retrospective cohort study involved 3375 AC-FET cycles with follicular-phase depot GnRH agonist administration between January 2017 and December 2020. Subjects were divided into a study group (cycles with cyst formation) and a control group (cycles without cyst formation). The study group was matched by propensity scoring matching with the control group at a ratio of 1:2. For patients with ovarian cyst formation, two major managements were used: a conservative approach (i.e., expectant treatment) and a drug approach (i.e., continued agonist administration). The primary outcome was live birth rate (LBR).
RESULTS
The incidence of functional ovarian cysts following pituitary downregulation is 10.1% (341/3375). The study group exhibited a LBR similar to the control group (54.5% . 50.1%, adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 0.88-1.56, 0.274). Patients with a lower body mass index and anti-Müllerian hormone, and a higher basal estradiol level were more susceptible to developing functional ovarian cysts. The LBR decreased after the drug approach compared with the conservative approach, but not significantly (aOR 0.63, 95% CI 0.35-1.14, 0.125). Following the conservative approach, cycles arrived at live births had a significantly shorter duration from the detection of functional cysts to the start of endometrium preparation (15.7 ± 5.1 days . 17.4 ± 5.3 days, = 0.009) and a significantly higher proportion of ovarian cysts on the initial day of exogenous hormone supplementation (51.4% . 30.3%, = 0.001). After controlling for all confounders, the differences remained statistically significant.
CONCLUSIONS
It is unnecessary to cancel cycles that experience functional ovarian cyst formation. Conservative management and further agonist suppression protocol had similar pregnancy rates. However, a conservative approach was recommended due to its lower cost and fewer side effects. Our findings support a shorter waiting period when choosing the conservative protocol.
Topics: Embryo Transfer; Female; Gonadotropin-Releasing Hormone; Humans; Ovarian Cysts; Ovulation Induction; Pregnancy; Retrospective Studies
PubMed: 35574002
DOI: 10.3389/fendo.2022.828993 -
Ultrasound in Obstetrics & Gynecology :... Jul 2017To explore the outcome of fetuses with a prenatal diagnosis of ovarian cyst. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To explore the outcome of fetuses with a prenatal diagnosis of ovarian cyst.
METHODS
The electronic databases MEDLINE and EMBASE were searched using keywords and word variants for 'ovarian cysts', 'ultrasound' and 'outcome'. The following outcomes in fetuses with a prenatal diagnosis of ovarian cyst were explored: resolution of the cyst, change of ultrasound pattern of the cyst, occurrence of ovarian torsion and intracystic hemorrhage, need for postnatal surgery, need for oophorectomy, accuracy of prenatal ultrasound examination in correctly identifying ovarian cyst, type of ovarian cyst at histopathological analysis and intrauterine treatment. Meta-analyses using individual data random-effects logistic regression and meta-analyses of proportions were performed. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale.
RESULTS
Thirty-four studies (954 fetuses) were included. In 53.8% (95% CI, 46.0-61.5%) of cases for which resolution of the cyst was evaluated (784 fetuses), the cyst regressed either during pregnancy or after birth. The likelihood of resolution was significantly lower in complex vs simple cysts (odds ratio (OR), 0.15 (95% CI, 0.10-0.23)) and in cysts measuring ≥ 40 mm vs < 40 mm (OR, 0.03 (95% CI, 0.01-0.06)). Change in ultrasound pattern of the cyst was associated with an increased risk of ovarian loss (surgical removal or autoamputation) (pooled proportion, 57.7% (95% CI, 42.9-71.8%)). The risk of ovarian torsion was significantly higher for cysts measuring ≥ 40 mm compared with < 40 mm (OR, 30.8 (95% CI, 8.6-110.0)). The likelihood of having postnatal surgery was higher in patients with cysts ≥ 40 mm compared with < 40 mm (OR, 64.4 (95% CI, 23.6-175.0)) and in complex compared with simple cysts, irrespective of cyst size (OR, 14.6 (95% CI, 8.5-24.8)). In cases undergoing prenatal aspiration of the cyst, rate of recurrence was 37.9% (95% CI, 14.8-64.3%), ovarian torsion and intracystic hemorrhage were diagnosed after birth in 10.8% (95% CI, 4.4-19.7%) and 12.8% (95% CI, 3.8-26.0%), respectively, and 21.8% (95% CI, 0.9-40.0%) had surgery after birth.
CONCLUSION
Size and ultrasound appearance are the major determinants of perinatal outcome in fetuses with ovarian cysts. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Female; Humans; Ovarian Cysts; Predictive Value of Tests; Pregnancy; Ultrasonography, Prenatal
PubMed: 27325566
DOI: 10.1002/uog.16002 -
Oncotarget Jan 2016Increased inclusion cyst formation in the ovary is associated with ovarian cancer development. We employed in vitro three-dimensional (3D) organotypic models formed by...
Increased inclusion cyst formation in the ovary is associated with ovarian cancer development. We employed in vitro three-dimensional (3D) organotypic models formed by normal human ovarian surface epithelial (OSE) cells and ovarian cancer cells to study the morphologies of normal and cancerous ovarian cortical inclusion cysts and the molecular changes during their transitions into stromal microenvironment. When compared with normal cysts that expressed tenascin, the cancerous cysts expressed high levels of laminin V and demonstrated polarized structures in Matrigel; and the cancer cells migrated collectively when the cyst structures were positioned in a stromal-like collagen I matrix. The molecular markers identified in the in vitro 3D models were verified in clinical samples. Network analysis of gene expression of the 3D structures indicates concurrent downregulation of transforming growth factor beta pathway genes and high levels of E-cadherin and microRNA200 (miR200) expression in the cancerous cysts and the migrating cancer cells. Transient silencing of E-cadherin expression in ovarian cancer cells disrupted cyst structures and inhibited collective cell migration. Taken together, our studies employing 3D models have shown that E-cadherin is crucial for ovarian inclusion cyst formation and collective cancer cell migration.
Topics: Apoptosis; Biomarkers, Tumor; Cadherins; Cell Culture Techniques; Cell Movement; Cell Proliferation; Female; Fluorescent Antibody Technique; Gene Expression Profiling; Gene Regulatory Networks; Humans; Microscopy, Fluorescence; Ovarian Cysts; Ovarian Neoplasms; Ovary; RNA, Messenger; Real-Time Polymerase Chain Reaction; Reverse Transcriptase Polymerase Chain Reaction; Tumor Cells, Cultured
PubMed: 26684027
DOI: 10.18632/oncotarget.6588 -
The Journal of Veterinary Medical... Dec 2017The clinical and pathological records of 44 domestic, female rabbits with an age ranging from 6-124 months (median age: 63.5 month) were assessed retrospectively for...
The clinical and pathological records of 44 domestic, female rabbits with an age ranging from 6-124 months (median age: 63.5 month) were assessed retrospectively for ovarian lesions. Included were all rabbits that underwent an ovariohysterectomy with a subsequent pathological examination of the genital tract between March 1997 and June 2016. Pathological examination revealed ovarian lesions in 12 of the 44 rabbits including follicular cysts (n=7), cystic rete ovarii (n=3), widespread ovarian necrosis with dystrophic calcification (n=2), ovarian adenoma (n=1). Clinical examination including radiographs only suggested ovarian disorders in two cases of ovarian necrosis with dystrophic calcification and in two cases of cystic rete ovarii. Clinical significance was only conclusive in a case of cystic rete ovarii.
Topics: Adenoma; Animals; Female; Follicular Cyst; Necrosis; Ovarian Cysts; Ovarian Diseases; Ovarian Neoplasms; Ovary; Rabbits; Retrospective Studies
PubMed: 29057758
DOI: 10.1292/jvms.17-0358 -
Asian Journal of Surgery Feb 2024
Topics: Female; Humans; Retroperitoneal Space; Cysts; Ovarian Cysts; Peritoneal Diseases; Diagnosis, Differential
PubMed: 38008624
DOI: 10.1016/j.asjsur.2023.11.076 -
Australian Family Physician 2015Ovarian masses are very common in pre- and postmenopausal women and are typically an incidental finding.
BACKGROUND
Ovarian masses are very common in pre- and postmenopausal women and are typically an incidental finding.
OBJECTIVE
This article aims to provide a systematic approach to an ovarian mass for general practitioners including investigations, risk of ovarian cancer and referral considerations.
DISCUSSION
Investigation for an ovarian mass includes both transvaginal and transabdominal ultrasound. Simple, anechoic cysts 200. Complications of ovarian cysts include cyst rupture and torsion. Torsion is a gynaecological emergency and requires urgent review.
Topics: Decision Support Techniques; Disease Management; Female; Guidelines as Topic; Humans; Mass Screening; Ovarian Cysts; Ovarian Neoplasms; Ultrasonography
PubMed: 25688960
DOI: No ID Found -
Medicina (Kaunas, Lithuania) 2003Ovarian masses may result from functional (nonneoplastic) cysts or benign or malignant neoplasms. In 1973, the World Health Organisation classified ovarian neoplasms... (Comparative Study)
Comparative Study Review
Ovarian masses may result from functional (nonneoplastic) cysts or benign or malignant neoplasms. In 1973, the World Health Organisation classified ovarian neoplasms into nine major categories and 26 subtypes, based on histologic cell type and benign versus malignant state. The literature review concerning functional ovarian cysts in girls has been presented. Functional cysts are not true neoplasms but rather should be considered a variation of a normal physiologic process. Functional cyst include follicular, corpus luteum, and theca-lutein types, all of which are benign and usually self-limited. The incidence of functional cysts in the community is probably even higher than indicated in most series, as percentages are based on referred cases and it is not possible to determine the underlying incidence of nonidentified or asymptomatic cysts. Incidence, etiopathogenesis, clinical symptoms, methods of diagnostics, treatment and results of functional cysts in fetus and newborns, in children and adolescents are discussed.
Topics: Adolescent; Adult; Age Factors; Algorithms; Child; Child, Preschool; Estrogens; Female; Fetal Diseases; Gestational Age; Humans; Incidence; Infant; Infant, Newborn; Laparoscopy; Laparotomy; Magnetic Resonance Imaging; Menstruation; Ovarian Cysts; Pregnancy; Tomography, X-Ray Computed; Ultrasonography, Prenatal
PubMed: 14515055
DOI: No ID Found